Siegenthaler Giordano M, Rizzi Mattia, Bettinelli Alberto, Simonetti Giacomo D, Ferrarini Alessandra, Bianchetti Mario G
Department of Pediatrics, Mendrisio and Bellinzona Hospitals, University of Bern, Bern, Switzerland.
Pediatr Nephrol. 2014 Feb;29(2):235-9. doi: 10.1007/s00467-013-2621-6. Epub 2013 Sep 24.
Little information is available on ureteral or vesical involvement in Henoch-Schönlein syndrome. To determine the features of this condition we performed a formal analysis of peer-reviewed scientific literature on this topic.
The US National Library of Medicine database was used as the data source. All articles published as full-length articles or letters were collected. Reports published in languages other than English, French, German, Italian or Spanish were not considered.
We analyzed 32 reports describing 35 cases (24 male and 11 female subjects aged between 3.5 and 63, median 7.0 years) with ureteral (n = 30), vesical (n = 4), or both ureteral and vesical involvement (n = 1). The presentation included colicky abdominal pain, macroscopic hematuria (sometimes containing blood clots), urinary tract infection or urinary retention. The diagnosis of ureteral involvement was often fortuitous. Patients with vesical involvement were managed conservatively. However, the majority of those with ureteral involvement were managed surgically.
Ureteral or vesical involvement is unusual and likely underappreciated in Henoch-Schönlein syndrome. Improved recognition and wider appreciation of this involvement can help to avoid associated morbidity. Management must be individualized for each patient. A multidisciplinary approach may be of value in planning medical treatment, surgical intervention, and follow-up.
关于过敏性紫癜累及输尿管或膀胱的信息较少。为了确定这种情况的特征，我们对关于该主题的同行评审科学文献进行了正式分析。
以美国国立医学图书馆数据库作为数据源。收集所有以全文文章或信函形式发表的文章。不考虑以英语、法语、德语、意大利语或西班牙语以外的语言发表的报告。
我们分析了32篇报告，描述了35例（24例男性和11例女性，年龄在3.5至63岁之间，中位年龄7.0岁）输尿管受累（n = 30）、膀胱受累（n = 4）或输尿管和膀胱均受累（n = 1）的病例。临床表现包括绞痛性腹痛、肉眼血尿（有时含有血凝块）、尿路感染或尿潴留。输尿管受累的诊断往往是偶然的。膀胱受累的患者采用保守治疗。然而，大多数输尿管受累的患者接受了手术治疗。
输尿管或膀胱受累在过敏性紫癜中不常见，可能未得到充分认识。提高对这种受累情况的认识和更广泛的了解有助于避免相关的发病率。管理必须针对每个患者进行个体化。多学科方法在规划医疗治疗、手术干预和随访方面可能具有价值。
